From energy to the NHS, all the next Tory leader can offer is an information blackout

In this Tory leadership contest, there has been a vogue for catching out candidates with things they once said: Liz Truss calling for a republic back in the days when she was a Liberal Democrat or a young Rishi Sunak boasting that he didn’t have any working-class friends. But it won’t be long before whoever wins is caught out by the things they didn’t say at all. We’ve heard more than enough about the differences between the two on tax and inflation but there has been a conspiracy of silence on some of the biggest problems facing this country, as though both contenders either don’t want to know how bad things are or know that they don’t have the mettle to solve them.

Both have fought furiously over whether their economic plan will help Britons avoid an extremely expensive and miserable winter. But beyond bickering about their tinkering to help with the cost of energy bills, neither Truss nor Sunak has confronted the underlying problems that Britain has with its energy supply that make it more vulnerable should Vladimir Putin decide not to turn the gas back on. The impact of the war in Ukraine on fuel prices is something no prime minister can really control but the government and both leadership contenders are also shirking the things they can control. There has been no discussion of an emergency plan to deal with energy supply or energy demand. Britain’s housing stock is leakier than a sieve, which means the heating people can afford quickly escapes through the walls of their homes. We are still building properties that are sufficiently energy inefficient to need retro-fitting in the same way as homes built in the 1960s and 1970s. However old or new our homes are, they need a national programme of insulation.

Before it has even reached homes, our energy is in short supply and delivered on a short-term basis rather than through long-term contracts with fixed prices. Sunak has flip-flopped over whether to back onshore wind farms and he and Truss have criticised solar farms – both topics of interest to Tory members but of little consequence to the wider problem of energy independence. Beyond that, there’s a blackout on how difficult this winter might be or on how this country might avoid similar problems in the coming years.

If they’re not staring at their energy bills in disbelief, many Britons will be looking at letters from their local hospital explaining the lengthy waits for treatment. Some will already have been unlucky enough to be stuck for hours in an ambulance outside a full accident and emergency unit – or perhaps that’s luckier than those who have waited and waited for an ambulance to turn up at all.

Both Truss and Sunak have paid lip service to the challenges facing the NHS: acknowledging that there is a backlog in treatment and that the service is under pressure more widely but neither offers any suggestion of a wish to understand the drivers behind the current crisis, let alone how to reform them. Sunak wants to fine people for missing GP appointments, which sounds popular but which those actually working on efficiencies in the health service say would cost more to administer and penalise the vulnerable who fail to turn up, such as new mothers with psychiatric problems. Meanwhile, Truss told one hustings: “What I want to see is fewer layers of management in the National Health Service and less central direction.” It was the perfect leadership contest soundbite: designed to appeal to the innate suspicion of just about every layman (and indeed a fair few doctors) towards the idea that a health service the size of a small country might need any managers.

However, as Truss’s hero Margaret Thatcher soon discovered, the NHS needs managers; it was in the 1980s that the Conservatives introduced layers of management to replace a very haphazard way of running the service. It may well be that the structure of those layers isn’t right, but Truss would be shaking up a health service that is only just getting to grips with the latest set of Tory changes to the way it works, in the form of the Health and Care Act 2022.

Both candidates talk vaguely about the importance of “efficiencies”, even though the NHS is already working with a real-terms funding cut caused by inflation and pay rises the service must find from existing budgets (and which aren’t going to stop some staff taking industrial action).

Still, it’s much easier to criticise managers and central control than wonder whether there are things the centre could do to make the NHS more efficient. Sunak was key to blocking a proper NHS workforce plan when at the Treasury, though that would only have dealt with the future shortages of doctors and nurses without filling the current black hole. He now talks with real pride of his health and care levy as though this has really done anything to reform one of the key drivers of high NHS demand: a social care system that has been in crisis for more than a decade.

One of the big lessons from the pandemic, in case anyone hadn’t learned it before, was how many patients in hospitals don’t actually need to be there. When the NHS discharged 25,000 people from acute care settings into the community in 2020, it served as a lesson, now already largely forgotten, in how patients could move out of hospital if the cash was found to fund their social care.

The cash is long gone and one of the reasons ambulances wait and operations are delayed is that there are, once again, thousands of patients who cannot safely leave hospital while their local authority fails repeatedly to find them a care package. Neither Sunak nor Truss will talk about this because to do so would be to admit that in 12 years the Conservatives have failed to do anything meaningful about social care and, what’s more, their national insurance hike won’t even benefit the sector for the first few years. Neither wants to upset Tory members or voters with talk of tax rises or the other trade-offs needed for a properly functioning care system and so it suits both to skirt around the issue.

Another crisis that both are happy to edge around is law and order. A laughable moment in this surreal campaign came when Truss used the old phrase “back to basics”, which immediately conjured memories of the dying embers of the last lengthy Conservative government in the mid 1990s. Back then, it was John Major’s attempt to reset his limping administration that became associated with sleaze scandals. Now, it’s an instruction to the police to get “back to basics” and cut key crimes by 20% before the end of this parliament. Fair enough, perhaps, but a pledge that “burglars, thugs and murderers should expect to be taken off our streets and thrown behind bars” would be more meaningful if Truss were also prepared to go back to basics with the criminal justice system as a whole.

Sunak, too, is keen to talk justice, suggesting a number of new criminal offences and a beefed-up victims and sentencing bill. Yet the system is in such a state of disarray that I was recently not surprised when a number of workers in the domestic and sexual violence sectors privately told me they couldn’t, in all good conscience, recommend that the survivors who they worked with should go through the courts. In their view, the only thing that was guaranteed by that was that they would spend years being retraumatised by long delays, lost evidence and, eventually, their attacker being acquitted. There are nearly 60,000 outstanding cases in crown courts. As with the NHS backlogs, these delays were building even before Covid.

Perhaps you can’t blame Sunak or Truss for glossing over these problems: after all, they need to be elected first. That Truss’s promises of a recovery fuelled by tax cuts have had more traction with Tory members than Sunak’s insistence that he’s being honest about the difficult choices would suggest members don’t want to hear a long list of problems that the Conservatives still haven’t fixed after more than a decade in charge. They are happier, perhaps, with an unreal picture that suggests just a few tweaks are needed here and there to get things running once more.

Maybe the pair do both have special secret plans to make the government work again – to be revealed in the highest office. Or perhaps we can’t blame them, because this refusal to confront problems is one that successive administrations have indulged in, each hoping the next lot will take responsibility. Either way, even after another month of these endless hustings, television debates and members’ meetings,we will probably be none the wiser about whether the next prime minister understands the scale of the problems they face, still less how to solve them.

• Isabel Hardman is assistant editor of the Spectator